经皮椎弓根螺钉短节段固定撑开复位治疗胸腰椎骨折的效果及对VAS评分的影响

Effect of percutaneous pedicle screw short-segment fixation and distraction reduction in treatment of thoracolumbar fractures and its influence on VAS score

目的探讨经皮椎弓根螺钉短节段固定撑开复位治疗胸腰椎骨折的效果及对VAS评分的影响。方法选取2016年2月至2020年5月在我院门诊及住院诊断为胸腰椎骨折的患者70例为观察对象,按照入院时间先后顺序将患者平均分为两组,对照组(先入院35例患者)、观察组(后入院35例患者),前者利用常规开放式内固定治疗,后者利用经皮椎弓根螺钉短节段固定撑开复位治疗,对不同治疗措施下患者的手术用时、术中出血量、总住院时间及伤椎椎体后凸Cobb角及VAS疼痛评分进行比较。结果观察组患者的手术用时(103.47±28.01)min、术中出血量(118.32±30.22)mL、总住院时间(10.72±2.33)d,均低于对照组患者的手术用时(118.32±30.22)min、术中出血量(354.65±115.49)mL、总住院时间(18.64±5.79)d,差异有统计学意义(P<0.05);治疗前、术后1 d及术后6个月患者伤椎椎体后凸Cobb角及VAS疼痛评分比较,差异无统计学意义(P>0.05)。结论对于胸腰椎骨折患者而言,经皮椎弓根螺钉短节段固定撑开复位治疗疗效显著,且具有创伤小,患者术后恢复快的优势,具有临床应用价值。

Objective To explore the effect of percutaneous pedicle screw short-segment fixation and distraction reduction in the treatment of thoracolumbar fractures and its influence on the VAS score.Methods Seventy patients diagnosed with thoracolumbar fractures admitted to our hospital from February 2016 to May 2020 were selected.They were divided into two groups according to the order of admission time,as the control group(the first 35 patients admitted to the hospital)and the observation group(the latter 35 patients admitted to the hospital).The control group were treated with conventional open internal fixation,and the observation group were treated with percutaneous pedicle screw short-segment fixation and distraction reduction.The differences in operation time,intraoperative blood loss,total hospital stay,Cobb angle of injured vertebral kyphosis,and VAS pain score were compared between the two groups.Results The operation time(103.47±28.01)min,intraoperative blood loss(118.32±30.22)mL and total hospital stay(10.72±2.33)d of the observation group were lower than those of the control group,which were(118.32±30.22)min,(354.65±115.49)mL and(18.64±5.79)d,with statistically significant differences(P<0.05).There were no statistically significant differences in the Cobb angle of injured vertebral kyphosis and VAS pain score before operation and at 1 day and 6 months after operation between the two groups(P>0.05).Conclusion Percutaneous pedicle screw short-segment fixation and distraction reduction has a significant effect in the treatment of thoracolumbar fractures,with less trauma and quicker recovery after surgery.It has clinical application value.